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Giving antibiotics regularly to people with cystic fibrosis to prevent infection with a germ called Staphylococcus aureus Updated

Smyth AR, Walters S
Published Online: 
24 November 2014

Review question

We reviewed the evidence about the benefits and adverse effects of giving regular antibiotics to people with cystic fibrosis to prevent infection with a germ called Staphylococcus aureus.

Background

Cystic fibrosis blocks the airways with mucus and causes frequent airway infections. These can lead to death from breathing failure. People with cystic fibrosis are sometimes given regular antibiotics to prevent infections from a germ called Staphylococcus aureus. However, antibiotics can also have adverse effects.

Search date

The evidence is current to: 04 September 2014.

Study characteristics

The review includes four studies with 401 children; there were no adult studies. Volunteers were put into groups at random and received either an oral antibiotic continuously as a prevention for at least one year or no antibiotic treatment to prevent infection with Staphylococcus aureus. All volunteers could be given additional antibiotics if their doctor thought they needed them based on symptoms and germs grown in their respiratory secretions. Studies lasted for a maximum of six years.

Key results

The review found some evidence that giving regular antibiotics to young children (continued up to six years of age) leads to less infection with Staphylococcus aureus. For other outcomes in the review, there was no difference between giving regular antibiotics or not. Since none of the studies lasted longer than six years, we can't draw any conclusions about long-term use. Also, since all studies were in children, we can not comment on the use of these drugs in adults. Future research should look at patterns of antibiotic resistance and patient survival.

Quality of the evidence

All the studies were of variable quality. We judged that the two older studies had a higher risk of bias overall compared to the two newer studies. In particular this was because those taking part in the studies (or their parents or caregivers) would be able to guess which treatment they were receiving, and also one study did not state if anyone had dropped out and if so what the reasons were. Only the newest study seemed to be free of bias, although even here we were not certain if the study results were affected by the way the data were analysed.

This record should be cited as: 
Smyth AR, Walters S. Prophylactic anti-staphylococcal antibiotics for cystic fibrosis. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD001912. DOI: 10.1002/14651858.CD001912.pub3
Assessed as up to date: 
20 November 2014